SAFETY

[WestSideBorderPatrol]

How do they lift the backboard? Maybe the have backboards that work like the skateboard in Back to the Future. That would be cool.

Huh? How do who lift the backboard? The providers? They can lift the backboard, but they have issues with the stretcher b/c leverage doesn't work in their favor. They're short and the height at which the stretcher needs to be at to go in the ambo makes it hard for them to lift b/c the handle height is basically at the max height they can lift to.

[mrmeaner]

As far as the electric stretcher, they're great! However, our power stretcher is about 50lbs heavier than a standard stretcher and some of the more petite providers have trouble with it.

Huh? How do who lift the backboard? The providers? They can lift the backboard, but they have issues with the stretcher b/c leverage doesn't work in their favor. They're short and the height at which the stretcher needs to be at to go in the ambo makes it hard for them to lift b/c the handle height is basically at the max height they can lift to.

Sorry, read it as the weight being the problem, not the height.

[mrmeaner]

Misdemeanor excellent post. We are way behind, even consider the back door lift that the UK uses that helps stop on job injuries. I do agree we need to slow down even on serious patients. At high rates of speed you cannot work in the back thus doing more harm than good to everyone. Lets run with this.

http://publicsafety.com/article/article.js...p;siteSection=2

http://www.emergencydispatch.org/articles/...nsporttime1.htm

http://www.hurontalk.org/PDF/Kaman.pdf

These studies were performed in urban areas, so the numbers will vary from rural studies. But in the case of rural trauma, most likely a helicopter is going to be part of the transport of the patient as most likely the hospital will not have surgical services. With all this information available, it's really disappointing that there are still so many issues because of ambulance accidents. Here in Wisconsin, the state EMS association has released a statement regarding the operation of ambulances. I know this is not a ground breaking event, but it's still steps in the right direction.

[spenac]

Well I would hope that safety would be something we can all try to get behind. I have been injured when flung around in the box. I have informed my wife that odds are if I crash they will just bring her some ashs from the seen and tell might be him. The reason no progress has been made here is we are not organized in anyway, but that is discussed on other threads. We do need to start demanding safer ambulances.

[Just Plain Ruff]

I thnk one thing that is constantly overlooked is scene safety.

Not so much scene safety on accident scenes cause that could take up an entire thread.

I wrote an article for the new EMS journal Fieldmedics Magazine and I pointed out the most common dangerous scenes we encounter. Car wrecks are pretty dangerous but let's look at the lesser ones.

Crowds - all it takes is one person to get riled up and you could have problems with others.

Domestic violence - even though there are two or more cops there that also means that there are at least 2 if not 4 guns there. Two in the holster and 2 backups.

Rodeos - ever get the crowd yelling at you to get your asses in there to help the cowboy when the bull is still in the ring? You get a bunch of drunk cowboys and you can see where things might get a bit out of hand especially if it is another cowboy that's hurt.

Any scene that was caused by violence - the victims family and friends are mad, the suspect may still be at large, the suspect might be hurt too. Get that emotionally charged of an incident and you have issues just waiting to happen.

Our jobs are chock full of other situations that I cannot describe in detail in this thread but the education of our providers should include at least one day of real-life scenarios of dangerous situations. From the dangerous car wreck scene to the domestic violence incident.

This training should be performed by competent law enforcement personnel who know how EMS thinks and works. There should be real life scenarios that seem safe to begin with but escalate out of control and how the medic and crew should handle the situation. But in a safe controlled environment.

We also should look at how the crews react to common stressors and teach them to deal with those stressors in a positive way.

I know my scene safety lecture was 30 minutes long. But had I have had a set of real life scenarios to show me how things can go from good to terrible, I think I would have been prepared for the unexpected. But I wasn't and didn't know how to deal with at least one situation which came up about a year into my career. I won't get into it but to say the least it was a near career ending situation.

I had a second near career and life ending situation about 8 years later but with experience I knew how to handle it and lived to see another day.

You have to have scene safety education and what is currently taught is minimal at best.

[Dale]

Uhh- I thought the topic was Apparatus Safety- not scene safety issues. Your points are very valid but they may be in the wrong forum topic so they may not get widespread viewing.

[Just Plain Ruff]

There are many things out there that are unsafe for us as EMT / PARAMEDICS... tell me what you want to see safer, and HOW if you have an idea....

That's the topic.

I think that scene are inherently unsafe for us so I suggested ways to improve them. I know we can't completely make scenes safer but we can go a long way in making them safer for us by increasing our awareness, increasing the odds that we all go home safe in the end.

I saw nothing in the topic that made it exclusively apparatus safety, that was the way the thread went though.

[Dale]

sorry!- was simply going by the header at the top of the page indicating "Apparatus" under the Technology section.

[Richard B the EMT]

I had the misfortune of being injured on the job, at the FDNY EMS Station at Kings County Hospital, while being a participant in a city wide drill. I was Transported by an AMR type 2 ambulance, working under contract to the Kingsbrook Jewish Hospital and the NYC 9-1-1 system.

This ambulance had something I first heard about somewhere in this website: a "Nurse-Catcher". First time I had seen one in person, and the crew had never heard the term before. For the uninformed, it looks like a cargo net, set towards the head end of the "crew bench", and presumably for catching anybody falling towards the front end of a suddenly de-accelerating ambulance. Seat belts are better, per myself, and a host of others on EMT City.

[Dale]

the "cargo net" you describe has actually been around in some form for quite some time but like many items, it is slow to catch on in some areas, especially with traditionalists. You will find many strong opinions either for or against it. It does provide an additional level of occupant protection for those that may be sitting on the squad bench who are not wearing the provided seat belt for whatever reason.

Many ambulance dealers and manufacturers specifically refrain from calling it anything but a cargo net since they don't want to imply that it provides any kind of occupant protection or restaint. Ain't that grand- so why provide something that you don't otherwise endorse for occupant safety? There are reasons- see below.

Be warned that some of these so-called "nurse catchers" are actually poorly-designed and consist of questionable-strength webbing that may be fabricated with stitching that does not meet FMVSS standards (like those required for the seat belts.) The nets can also be constructed of much smaller webbing sizes with large "gaps" between the horizontal and vertical "bands that provide questionable "restraint.". Lastly, the attachments for the nets at ceiling and squad bench level can be questionable so in a major deceleration by someone, the fasteners may not be able to handle the impact load.

The best nets are ones manufacturered using the same kinds of webbing, stitching methods, and assembly as those used for seat belts (and not backboard straps!) Look for nets that use quick-connect seat belt hardware to allow for ease of cleaning, secure attachment, and the necessity of removing the net when necessary to access the head of any supine patient on the squad bench (i.e. intubation, BVM ventilation.)

The recent revisions to the AMD (Ambulance Manufacturers Division) of NTEA now include specific performance and testing criteria for such nets to provide an acceptable level of restraint. It requires specific strength testing to demonstrate its ability to handle typically deceleration incidents.

One can only presume that this long needed standard was developed in response to input and experiences by EMS personnel that may have had "less than optimal" experience with some of these net designs on some vehicles.